The present invention relates generally to surgery and the placement of sutures, and more particularly, to devices and methods for the suture repair of tissue, for example, tears of the dura mater that occur during spinal surgery.
Tears of the dura mater (durotomy) are a relatively common occurrence during spinal surgery. Incidences of durotomy can vary by procedure and can be an additional challenge during surgical repairs such as, for example, lumbar surgeries or the like. Moreover, it is desirable to form a substantially watertight closure of the dura mater to limit and/or avoid, for example, cerebrospinal fluid (CSF) leaks that can otherwise lead to patient complications including spinal headaches, meningitis, spinal fluid fistula, and epidural abscess.
Surgical closure techniques using sutures is a common approach to dural repair. In some instances, however, these techniques can be difficult to execute due to anatomic constraints, obstruction of visualization by CSF or blood, and the close proximity to the nerve rootlets. In some instances, these challenges can be further complicated when using minimally invasive techniques such as, for example, a tube retractor system. In some such instances, surgeons may choose not repair the durotomy or they may attempt to repair the durotomy using traditional suturing tools. Such tools and devices can be limited and, in some instances, lack maneuverability to avoid obstructions and/or to enable adequate passage of the needle and suture through the tissue. As a result, surgical repairs of the dura mater are often time consuming and expensive.
Thus, a need exists for methods and apparatus for the suture repair of tissue such as, for example, tears in the dura mater of the spine.